Program

Home Start

Home Start
is a home visiting program that was created to determine whether the
home-visiting approach might be more effective than Head Start’s center-based
approach. The program’s goal is to foster healthy families in order to create
safe and nurturing environments for children. Specifically, Home Start aims to
empower a mother to be a successful teacher for her children in their own home.
Several impacts have been found during the program, but mostly toward the last
year of it. Impacts have been found for school readiness, detection of
developmental problems, staying on task, and some aspects of nutrition. Impacts
have also been found for the parent variables of mother involvement, number of
books and playthings in the home, and housing authority resource use.

DESCRIPTION OF PROGRAM

Target
Population:
Children
in families at risk of child abuse or neglect

Home Start
is a one-year, home-visitation program. It is designed to empower mothers to be
successful teachers for their children in their own homes. The home visitors
come once or twice a week, and they discuss topics with the parents, refer the
parents to agencies for services, and inform parents about group activities with
other Home Start parents. The visitors discuss child development, nutrition,
health, and needs of family members.

Evaluated
Population:
Two-hundred fifty-one Home Start parents and 162 control parents from six sites
were evaluated. The parents were mostly from low-income households, and mothers
had a mean of 9.7 grades completed. About 28 percent of mothers graduated from
high school, 41 percent of families had neither parent employed, and mother’s
mean age was30. Eighty-five percent of children were up-to-date on
immunizations, but had not seen a doctor in about eight months. Forty-five
percent of families were receiving public assistance. On average, the children
themselves were below the mean for height and weight and did not receive the
required nutrition for their age.

Approach:
Families
were randomly assigned to the experimental group or a delayed-entry control
group. Data were collected at baseline, six months, and twelve months. The
authors collected data on school readiness, developmental problems, foods eaten,
nutrition, height, weight, parent-rated behavior, community interviewer-rated
behavior, child’s home environment, mother’s behavior, child’s medical history,
parent’s involvement in activities outside the home, and parent’s use of
community resources. School readiness was measured by two tests, one on general
knowledge and one on basic concepts. Developmental problems screened were fine
motor adaptive, language, gross motor, and personal-social. Child food intake
was reported by the mother, who told the interviewer what the child had eaten in
the 24 hours prior to the interview. The parent-reported behaviors were task
orientation, extraversion-introversion, and hostility-tolerance. The community
interviewer rated the child’s overall behavior during the interview by means of
nine “bipolar adjectives,” such as resistive-cooperative or quiet-talkative.
Then, he or she measured the child’s behavior during the testing.

The parent
measures were mostly self-report. The child’s home environment was measured by a
questionnaire filled out by the parent. The questionnaire consisted of
constructs measuring warm mother involvement, a checklist of available
playthings, and measured formal teaching by the mother, whether the child helps
with household tasks, if books or reading were available, supportive behavior,
and style of punishment. The parent was also interviewed and reported on the
child’s medical history, specifically the length of time since the child last
saw a doctor, reasons for the most recent doctor visit, and help available
outside the family for arranging doctor visits. Parent participation in
community activities outside the home was also measured and includes, but is not
limited to, the PTA, church organizations, Boy Scouts, Girl Scouts, 4-H, and
political organizations.

The
community interviewer filled out a scale on the mother’s behavior after the last
visit with the family, and observed the mother and child in an eight-block
sorting task. The parent’s comments were grouped into nine categories: request
talking, request understanding, request placement, talk about, unclassified,
feedback, correction, child talk, and child classified. There were only three
categories for behavior: mother moves blocks, mother punishes, and child moves
blocks.

Results:
The Home
Start program had a significantly higher report of the number of vitamin-A
vegetables consumed by the child compared with the control group. All other
child variables were not significant. For the parent variables, the Home Start
group reported using more outside help when arranging doctor visits compared
with the control group. All other parent variables were not significant. No
impacts were found on the block sorting task.

Approach:
Report
five is a summary of the three-year evaluation taking place from 1972 to 1975.
The same variables as the previous report were collected, as well as whether the
child had been to the dentist.

Results:
The
program had favorable impacts on the following child variables: overall school
readiness, presence of developmental problems with language, the number of
task-related comments the child made during the block task, parent-report of
child’s task orientation, weight, milk consumption, meat consumption, number of
months since the previous doctor visit, reason for doctor visit (Home Start had
a higher number of check-up appointments while the control group had a higher
number of illness-related appointments), and whether the child had been to the
dentist. Parent variables that were significant were the following: mother
involvement at home, child helps with household tasks, mother teaches child, the
mother’s comments made by the mother during the block task, type of behavior
during the block task, number of books in the home, number of playthings in the
home, and housing authority resource use.